Azoximer bromide

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Azoximer bromide, sold by the trade name Polyoxidonium by Petrovax NPO, is a water-soluble cationic polymer, adjuvant for use with the hemagglutinin glycoprotein-based influenza vaccine Grippol. Azoximer bromide is a ternary copolymer of 1,4-ethylene piperazine, 1,4-ethylene piperazine-N-oxide, and (N-carboxymethylene)-1,4-ethylene piperazinium bromide with a molecular weight of 60–100 kDa. A derivative of poly(1,4-ethylene piperazine), it is synthesized by a partial oxidation of the parent polymer with hydrogen peroxide to introduce N-oxide groups followed by the quaternization of non-oxidized amino groups with bromoacetic acid. Azoximer bromide is registered under US Patent-5503830 from 1996, and in the Russian Federation from 1996, under registration number 96/302/9, FS 42-3906-00. In Slovakia, azoximer bromide 6 mg lyophilisate for solution for injection has been authorized since 2002 for the treatment of diseases accompanied by secondary immunodeficiency in adults, including acute and recurrent infections, allergies, septic conditions, post-surgical complications and treatment-induced immune deficiency. The clinical effectiveness of azoximer bromide has not been confirmed by independent clinical studies that meet modern standards of evidence-based medicine: there are few double-blind randomized and placebo-controlled studies with a sufficient number of participants and the publication of results in well-regarded scientific journals with high impact factors.